Rotator cuff tears are very common and have been notoriously hard to heal. Now, a local doctor is using a new bio-implant, helping to make that healing a little easier.
"Probably greater than half my practice is shoulders," notes Dr. David Rubenstein, a sports medicine specialist at Main Line Health's Lankenau Medical Center.
Dr. Rubenstein deals with all kinds of injuries but sees a lot like Joel Peskin's: rotator cuffs worn out from decades of work or sports, like hockey.
"50 years, from the time I was 10," Joel notes of his hockey career.
And also from about 35 years of playing golf.
The rotator cuff is a group of muscles and tendons surrounding the shoulder joint.
"It acts as a stabilizer to keep the ball in the center of the socket," says Dr. Rubenstein.
However, it's prone to damage from the reaching, lifting, and throwing we do.
"The ones that tear the most are the ones on top, because they're underneath the bone," he says.
Joel describes the development of his pain.
"It started out as a small, dull pain. And then it got consistently worse," he says.
Over time, Joel lost the power to shoot or take a pass and his golf game slowed down. Even daily tasks were affected.
"Picking up a cup of coffee with the arms out to the side was tough to do," he says.
Dr. Rubenstein says partial tears may not need to be fixed if they don't hamper daily life and for decades, fixing tears, especially full ones like Joel's, was challenging.
"A rotator cuff doesn't heal on its own," he says.
Doctors didn't have a reliable, consistent material to help them heal, but new patches like Arthroflex vastly improve success. It's built on a scaffold of collagen and elastin from human skin, with biologic enhancement.
"It's very strong and it's about four millimeters thick," Dr. Rubenstein says, making it ideal to be sewn or tacked into place.
For full tears, there's still generally six weeks of immobility and months of physical therapy. But some, like Joel, rebound faster. At two weeks, he could easily lift his arms.
And for partial tears, Dr Rubenstein says, "They can wear a regular sling, take it off as soon as they feel comfortable, move their arm immediately, and begin therapy."
Joel was pleased from start to finish.
"No problems at all. Excellent. Handicap's lower, bowling average is higher," he says.
Dr. Rubenstein says the field is evolving so quickly. He believes that within 20 years, replacement grafts will be even better and speed up healing even more.